HEALTH

HEALTH; Study Finds Less Cause for Worry on Nightmares

By DANIEL GOLEMAN

Published: March 15, 1990

There is reassuring news about sleep's most terrifying moment, the nightmare. A series of new findings show that though nightmares are far more common than scientists had thought, they rarely indicate deeper emotional problems.

The new results, emerging from a fresh round of studies on nightmares in recent years, depict nightmares as far less worrisome than professionals and lay people had thought. They suggest that therapists need not assume that even the most frightening dreams are necessarily a sign of emotional difficulties, although there are exceptions, particularly when the nightmare reflects the lasting impact of a trauma.

In some of the most recent studies, for example, highly anxious people had nightmares no more often than did those who are emotionally stable.

''We were quite surprised to find how common nightmares are,'' said James M. Wood, a psychologist at the University of Arizona in Tucson, who conducted the new study of nightmares and anxiety. It was reported last month in The Journal of Abnormal Psychology in an article produced with a colleague, Richard R. Bootzin.

Data on Frequency

In a study in which 220 men and women kept logs of their dreams for two weeks, Dr. Wood found that the number of nightmares ranged from none to 10 in the period, and that the average was about one. Previous studies of the frequency of nightmares had found an average of one every five weeks or so. But the earlier studies had simply asked people to estimate the number of nightmares they had in the last year, rather than ask them to keep track daily.

These frequencies may seem high to older people. In findings not yet published, Dr. Wood found that people from the age of 8 into their early 20's report have about 10 times as many nightmares as do people in middle age.

When people are asked how many nightmares they had during the last year, children aged 8 to 14 reported an average of 11, and college students an average of 9. But when the same question was asked of men and women aged 40 and over, the answer was one nightmare a year.

Dr. Wood has not yet had the opportunity to assess the frequency of nightmares in people in their late 20's and 30's, but he said there was ''almost certainly a gradual tapering-off in nightmare rates from the early 20's to middle age.''

Logs Yield Higher Levels

The actual incidence of nightmares is higher than people report when estimating for an entire year, Dr. Wood said. For example, the college students who recalled an average of nine a year reported a much higher average, 24 a year, when they kept logs each day.

The new data on nightmares in adults come from a survey of more than 2,000 people conducted by Dr. Mary Klink and Dr. Stuart Quan, both pulmonary specialists at the University of Arizona medical school. Their research was intended to compare sleep patterns of people who suffer from respiratory problems like asthma with patterns of those without such problems.

The data on children come from another study by Dr. Wood in which children aged 8 to 14 kept dream logs. The frequency of their nightmares was about one every week or two, he said, or ''about the same as with the college students.

Children under 8 are more prone to ''night terrors,'' which are distinct from nightmares. While nightmares usually occur in the same stage of sleep as other dreams, night terrors occur in the deepest stage, when dreams typically do not. Night terrors involve feelings of panic and fright so intense that the person wakes screaming.

Dreams' Relationship to Anxiety

The finding from Dr. Wood's research of most importance for clinicians is that there was no relationship between the person's usual level of anxiety and the number of nightmares.

''Our data suggest that anxious people may seem to have more nightmares because they are more likely to remember them or to complain about them,'' said Dr. Wood. ''But when people keep track on a daily basis, anxious people do not actually have more nightmares.''

And he added, ''If someone reports having lots of nightmares, it doesn't necessarily mean he's neurotic.''

Other researchers are coming to the same conclusion. One of the main researchers on nightmares is Ernest Hartmann, a psychiatrist who is director of the Sleep Disorders Center at Newton-Wellesley Hospital in Boston. He studied 150 men and women who have nightmares as often as three or four times a week.

''Even people with very frequent, disturbing nightmares do not necessarily feel a need for help for them,'' he said. One woman in his study, a talented painter and sculptor, ''had very bad, extremely vivid nightmares all her life: monsters, blood everywhere, being chased by scary men,'' Dr. Hartmann said. ''She would prefer not to have them,'' he added, ''but she was also able to use them in her art.''

One teen-ager Dr. Hartmann did feel needed treatment was not part of the study; he had been brought to the hospital for treatment of burns after a fire in which his brother had died.

''He was having terrible nightmares about the fire and his brother burning,'' said Dr. Hartmann. ''He was so upset by them that the skin-graft people were having trouble getting him to stay still.''

In that case, Dr. Hartmann said, the nightmares abated after brief psychotherapy focusing on the trauma of the fire and the guilt the boy felt for having survived while his brother died.

'Not a Sign of Mental Problems'

''Usually nightmares in themselves are not a sign of mental problems,'' Dr. Hartmann said. ''But even though most people I studied did not see nightmares as a problem, people should get therapy for them if they interfere with their lives.''

The one psychological disorder in which nightmares are a major problem is post-traumatic stress disorder.

According to Bessel Van Der Kolk, a psychiatrist who directs a trauma clinic at Harvard Medical School, repetitive nightmares that depict aspects of a traumatic event may cause several other symptoms of post-traumatic stress, like being jittery and easily startled during the day.

The psychiatric diagnostic manual lists ''dream anxiety disorder,'' in which a person is distressed by frequent nightmares, as a problem to be treated. But as Dr. Hartmann found, not all people who have numerous nightmares feel they need treatment.

One sign that treatment is called for, Dr. Van Der Kolk said, is repeatedly waking in terror from nightmares and being afraid or unable to go back to sleep. Another sign is when nightmares becomes such a concern that people try to rearrange their lives to avoid them.

''That's very common in post-traumatic stress,'' said Dr. Van Der Kolk. ''You see some people who handle it by staying up all night, getting a night-shift job, for instance, and then sleeping during daytime, when, for some reason, people seem less likely to have nightmares.''